Implants
Pay attention on the unjustified extractions of damaged teeth or dental roots before lose them! Take a second opinion to be sure that the extraction is really necessary. Removing the teeth because of the less clinical difficulties is not a sign of modernity or progress! Preservation and maintain of valuable teeth should be an aspiration of each dentist being worthy of respect.
The utilisation of the endoseeus implants allows to resolve the problems of missing teeth after their extractions and in the case of the incomfort removable dentures. Implants used especially to replace single missing teeth may present the most conservating option between the others actual treatments because it avoids teeth preparation -so important in the case of the intact adjacent teeth. The implant is like an artificial dental root placed in the bone of maxilla or mandible
and serving as a support for fixed prosthetic restorations (crowns, bridges) or as a strong anchorage (balls or bar retention systems) for the amovible prostheses.
- Pre-implantation diagnosis
The beginning patients’ selection to the implantation surgery and the implant supported restoration is based on the clinical exam, the analysis of the study casts and panoramic X-Ray. The most popular and valid diagnostic technique to investigate the state of host bone is the Computed Tomography exam with the radiological-surgical stent in the patient’s mouth. This exam permits the precise evaluation of the bone volume and the bone quality in the edentulous segment of the alveolar crest, as well the analysis of the emergency profile of the future prosthetic restoration.
The standard implant treatment has two stages:
- surgical stage–the atraumatic preparation of the implant bed in the host bone in the local anaesthesia and placement of the implant inside. The stress-free healing around the implant called popularly osseointegration is necessary to establish a direct contact between implant surface and the bone tissue. In the strict protocol the osseointegration requires a long healing period of at least 3-4 months in the mandible and at least 5-6 month in the maxilla. Premature implant loading may lead to fibrous tissues encapsulation instead of direct bone apposition and increased risk of implant’s mobility.
- Prosthetic stage – the realisation of the prosthetic restoration connected with the implant with special screw and the optimal functional loading of all construction. Patient’s selection already during first clinical exam has to eliminate the clinical cases with the biomechanically non- optimized prosthesis: unfavourable load conditions due to long abutments levers and too much angled loading.
An increasing number of well-controlled longitudinal studies have demonstrated that osseointegrated oral implants are a safe, predictable therapy for replacement of missing teeth, but patient's general health and local conditions don't always allow this therapy. There are the indications and the recommendations for implant treatment :
- A good state of general health
- The good anatomic and prosthetic conditions (the suffusing bone volume to place an implant and a prosthetic restoration)
- The good conditions of adjacent teeth to the missing teeth (the intact adjacent teeth or having the good quality fillings, no cavities or important mobility)
The local factors (anatomical contraindications to implantation, size and topography of prosthetic space, presence of cavities or tooth mobility, the quality of existing filings on the adjacent teeth with missing teeth) influence the most the choice between the conventional and the implant treatment.
A strict patient’s selection based on clinical and radiological exam (panoramic x-ray, scanner with radiological guide) is indispensable for the future long term functional and aesthetic success. Another essential problem in the implantology concerns as well the patients as the practitioners – not to focus only on the implant per se, but rather on the entire clinical problem to be solved.
The regular dental plaque control and check-up are necessary in the follow-up after treatment.
